Friday, August 07, 2009

Well, dear reader, I meant to start a discussion on health care earlier this year and wrote the following in February upon receiving my first bill of the new year All I’ve done is complete the thought as an introduction to my coming pontifications on the subject:

So, as the new year dawns my introduction to the coming 365 days of American health care is. . . another bill to call my insurance company about. Yes friends, my very first bill of the year requires my attention. To be honest, this is no surprise. I’d be hard pressed to think of a single statement or invoice that didn’t require my personal attention. If I didn’t call about an invoice it wasn’t due to it’s being miraculously correct but rather to a lack of energy on my part to take up battle with the insurance and medical billing industries. And I have “good” insurance! What is life like for all the poor schmucks out there with a bad insurance provider. To me it’s quite obvious that we grade insurance companies on a curve and the poor grade for the best performers lets the others of the hook. I don’t know anyone who isn’t wealthy who would venture to give their health insurance provider better than a C. I guarantee you that the stress caused by my health insurance is bad for my health and just about offsets any good it does me.

OK, so I’m certainly not the first to notice or comment on the pathetic service provision and high costs that distinguish the US health insurance industry. What makes my bitching any different from the myriad voices crying in the ether for attention? I’ve lived in different countries and experienced the benefits and pitfalls of different health insurance approaches. That certainly doesn’t make me an expert on health care and despite my years following the issue closely and being a reasonably assiduous consumer, I wouldn’t begin to claim that label. Still, the issue is what is it like to actually live with the various systems in various countries and what elements of the experiences of other countries should or could be transported to our own.

With that, and the hope of engaging in a reasonably rational and profitable debate about the actual issues surrounding our health care morass, I will be writing a series of posts on the issue. I expect them to break down roughly along the following lines:

A cursory examination of the main issues confronting US health care as I see them

A look at how the countries I’ve lived in confront these issues

A comparison of actually living with the health care systems of two different countries both with and without a family

A suggestion of how our system can be combine the best of the other systems with what, still, works in ours.

What I’m NOT going to do is look at the realities of our political system and the likely impossibility of enacting more than minor reform to our current, broken, system. I want to further the debate among reasonable people. There are legitimate differences of opinion and concern about all manner of tradeoffs that may be required to deal with the challenges we face in health care. I don’t deny that and don’t have a “quick fix.”

I’ll also be clear about my biases and I’ll do that right now:

I think it is an imperative that we look at health care as a basic human right.

I think that we should focus on providing health care for those who can’t afford it in our current system via regular health care practitioners and NOT via expensive and ineffective emergency services

I believe that we can have a healthier and more productive population by alleviating the stress of worrying about health care and concentrating on preventative care.

I believe that the wealthy will always have access to health care options most of us will not be able to afford regardless of our insurance coverage in either a public or private system

I believe there is a role for private insurers in health care

I believe that the government has a role to play

For the moment I’ll leave it at that. I’m going to try and keep this discussion free of unnecessary technical details but there will be enough dry data to go around. Feel free to comment and add to the discussion. I have no illusions about the reach or impact of my little blog but I do think we all have a responsibility to talk soberly about the great issues we face or we must accept the current stagnation and inevitable decline and societal discord this will lead to. Agree with me or not, please debate me.